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Questions 1 - 10
1

The nurse is caring for a patient with severe agoraphobia. What area of the hospital should the nurse avoid with the patient?

Wide-open spaces

Areas with lots of needles

Areas with lots of people

Enclosed areas

Explanation

A patient with agoraphobia has a fear of wide-open spaces.

2

The nurse completes a cervical exam on her laboring patient. She determines that her patient's cervix is 1cm in length. How would the nurse describe this length?

effaced

effaced

effaced

effaced

effaced

Explanation

The normal cervical canal is 2cm in length. Effacement is the thinning of the cervix as the body prepares for delivery. Thus, a 2cm cervix is 0% effaced and a 0cm cervix is 100% effaced.

3

Which agar would be the best choice option to identify_Escherichia coli_?

EMB (eosin methylene blue), because it is selective and differential

Nutrient agar

Selenium enriched media

Phenethyl alcohol

Explanation

The question requires the knowledge that Escherichia coli is a facultative, Gram negative, lactose fermenting bacteria. EMB (eosin methylene blue), or Mac (MacConkey) media is superior for isolating Escherichia coli because it is both selective and differential. Nutrient agar is neither selective nor differential. Selenium enriched media would not help identify this bacteria because Escherichia coli does not require this supplemented media to grow. Phenethyl alcohol can be used to select for anaerobic bacteria, which is of no utility in this situation.

4

What enzyme, present in saliva, initiates the digestion of carbohydrates?

Amylase

Lipase

Pepsin

Protease

Explanation

The digestion of dietary carbohydrates is initiated by amylase, an enzyme present in saliva. This enzyme breaks down long carbohydrate molecules into shorter units such as disaccharides. Lipase breaks down fats and is not present in the saliva, rather it is secreted by the pancreas into the duodenum. Pepsin is a protease - an enzyme that breaks down proteins. This enzyme is secreted by the chief cells of the stomach in its zymogen form (pepsinogen). It is activated by the product of the parietal cells (hydrochloric acid). Note that amylase is also secreted by the pancreas to complete the chemical digestion of carbohydrates into monosaccharides so that they can be absorbed by the brush border of the small intestine.

5

The nurse is caring for a patient with severe agoraphobia. What area of the hospital should the nurse avoid with the patient?

Wide-open spaces

Areas with lots of needles

Areas with lots of people

Enclosed areas

Explanation

A patient with agoraphobia has a fear of wide-open spaces.

6

A patient reports to urgent care for colicky pain in the upper right quadrant that they rate as a seven out of ten. The night before they ate a fatty meal with two glasses of wine. Which of the following tests would help you asses for cholecystitis?

Murphy's sign

Mc Burney's point

Psoas sign

Rovsing's sign

Explanation

A positive Murphy's sign is an indication of cholecystitis, or gallbladder inflammation. Testing for Murphy's sign is performed during an abdominal exam by asking the patient to breathe out slowly while the fingers of the examiner are slid under the right costal margin and held in place with firm pressure. The patient is then asked to inhale, which forces the abdominal contents upward. Murphy's sign is considered positive if the patient winces or flinches when breathing in, due to pain when the inflamed gallbladder comes in contact with the examiner's fingertips.

Rovsing's sign, psoas sign, and McBurney's point are all tests for appendicitis.

7

The nurse is caring for a patient with severe agoraphobia. What area of the hospital should the nurse avoid with the patient?

Wide-open spaces

Areas with lots of needles

Areas with lots of people

Enclosed areas

Explanation

A patient with agoraphobia has a fear of wide-open spaces.

8

What enzyme, present in saliva, initiates the digestion of carbohydrates?

Amylase

Lipase

Pepsin

Protease

Explanation

The digestion of dietary carbohydrates is initiated by amylase, an enzyme present in saliva. This enzyme breaks down long carbohydrate molecules into shorter units such as disaccharides. Lipase breaks down fats and is not present in the saliva, rather it is secreted by the pancreas into the duodenum. Pepsin is a protease - an enzyme that breaks down proteins. This enzyme is secreted by the chief cells of the stomach in its zymogen form (pepsinogen). It is activated by the product of the parietal cells (hydrochloric acid). Note that amylase is also secreted by the pancreas to complete the chemical digestion of carbohydrates into monosaccharides so that they can be absorbed by the brush border of the small intestine.

9

Alice is a 25-year-old female who is visiting her primary care physician for a routine physical. Which of the following may be conducted at the appointment?

A papanicolaou test

A rapid antigen detection test

A urine analysis

A cervical cerclage

A vaginal ultrasound

Explanation

A papanicolaou test (pap smear) may be preformed routinely on adult women as a screening for cervical cancer. A rapid antigen detection test (rapid strep test), urine analysis, cervical cerclage, or vaginal ultrasound would not be part of routine screening.

10

Actinic keratosis occasionally develops into which skin cancer?

Squamous cell carcinoma

Basal cell carcinoma

Melanoma

Merkel cell carcinoma

Explanation

Actinic keratosis occasionally develops into squamous cell carcinoma and is generally removed prophylactically. Actinic keratosis is not associated with development of any of the other skin cancer types listed.

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